RU2323681C2 - Method of correction of human functional condition - Google Patents

Abstract

FIELD: medicine; physiology and therapy.

SUBSTANCE: patient's cardiointervalograms are registered and analysed in real time mode. Respiratory movements are synchronised with own heart rate. Command information to man on inspiration-expiration is generated by microcontroller on basis of analysis of ongoing cardiointervalogram, and inspiration command is generated by microcontroller upon registration of cardiointervalogram's maximum and provided the time interval of analysis lockout is completed, when microcontroller's commands are pending even at extremum. Expiration command is generated upon registration of cardiointervalogram's minimum and the time interval of analysis lockout starts at expiration command with duration of three cardio cycles, or at inspiration command with duration of one cardio cycle.

EFFECT: method increases efficacy of systems of diagnostics and correction of human functional condition.

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Description

The invention relates to medicine, namely to physiology and therapy, and can be used in systems for diagnosing and correcting a person’s functional state.

The well-known "Method of functional psychophysiological correction of a person’s state and diagnostics in the process of correction" (RF patent No. 2221477), the essence of which is to visually present to the patient his own cardiac rhythmogram (cardiointervalogram) in real time, while the patient analyzes his cardiac rhythmogram and synchronizes his respiratory movements with oscillations of your own heart rhythm: when you increase the heart rate, you breathe in, and when the heart rate decreases, you exhale . Such cardiorespiratory synchronization (biofeedback training (BFB) of the cardiorespiratory system, cardiorespiratory BFB training) stimulates the vagus nerve and leads to patient relaxation. The disadvantage of this method is the active involvement in the analysis of the cardiac rhythmogram of the patient, which reduces the degree of relaxation. The second drawback is the attachment of the patient (subject) to the monitor, which imposes restrictions on the conditions for conducting biological feedback sessions and makes it difficult or even impossible to combine biological feedback sessions with other types of active load on the body (physical, psychological, etc.).

The objective of the invention is to increase the effectiveness of the impact on the autonomic nervous system of a person by means of cardiorespiratory synchronization with the organization of biological feedback by eliminating additional psychological burden on the patient in the form of an analysis of their own cardiointervalogram, as well as increasing the mobility of the entire complex of cardiorespiratory synchronization to combine biological feedback sessions with other types of active stress on the body by eliminating mandatory visual Noah connection of the patient with the complex.

The essence of the invention is to correct the functional state of a person by introducing into the biofeedback circuit a microcomputer recorder-analyzer that analyzes a cardiointervalogram and at optimal times generates control commands for inhalation-exhalation, which the patient obeys.

Figure 1 presents the structural diagram of the complex cardiorespiratory synchronization; figure 2 presents a cardiointervalogram with a delayed response of the heart rate (HR) to inhalation (with a "paradoxical" reaction); figure 3 presents the block diagram of the algorithm of the subroutine, providing analysis of the cardiointervalogram and the formation of control signals; figure 4 presents a comparison of real graphs of the cardiointervalogram during a session of cardiorespiratory biofeedback training of the proposed method and the method proposed in the prototype, in the same person; figure 5 shows a cardiointervalogram during a session of cardiorespiratory biofeedback training of the proposed method in combination with a uniform load on a bicycle ergometer. Figure 6 presents a cardiointervalogram when combining sessions of cardiorespiratory biofeedback training with an orthostatic test.

The method is as follows. Electrodes 2 of a microcomputer recorder-analyzer are applied to a person 1. The electrocardiogram potentials are amplified by the biopotentials amplifier 3, filtered by the filter block 4 and fed to the analog input of the microcontroller 5, whose program allows you to digitize the signal, select RR intervals, then record them in memory (block 7, Fig. 1), analyze and, in the result of the analysis, to form control signals for inhalation-exhalation, which are fed to the command issuing unit (block 6, Fig. 1). The block issuing commands affects the organs of hearing, and (or) vision, and (or) the sense of touch of a person, i.e. issues commands in a sound, and (or) visual, and (or) tactile form. A person obeys commands and makes respiratory movements that inversely affect RR-intervals (heart rate), i.e. the biofeedback circuit is closed. To achieve maximum relaxation, a lying position and / or with closed eyes is recommended.

As you know, when you inhale, the RR intervals are shortened relative to the initial level (heart rate increases), and when you exhale, the RR intervals are lengthened relative to the initial level (heart rate decreases). The process of monotonous reduction of RR-intervals during inspiration in most healthy people lasts approximately 4-7 seconds, and then, even with continued inspiration, RR-intervals begin to increase. The process of monotonically increasing RR intervals on expiration in most healthy people lasts about 3-5 seconds (and usually occurs faster than the process of monotonously decreasing RR intervals), and then, even with continued expiration, RR intervals begin to decrease. If at the moment of transition through the maximum of the cardiointervalogram the breathing phase is changed, then cardiorespiratory synchronization (the phenomenon of functional resonance of the cardiorespiratory system [1]) will occur with maximum vagus nerve stimulation and patient relaxation. The work of the selected prototype, as well as a number of other similar techniques, is based on this phenomenon [2, 3]. However, the organization of biological feedback in these methods implies active involvement in the analysis of the patient’s cardiorhythmogram, which reduces the degree of relaxation, and also forms the patient’s (subject's) attachment to the monitor, and this imposes restrictions on the conditions for conducting biological feedback sessions. It is possible to eliminate these shortcomings by introducing into the biofeedback circuit a microcomputer recorder-analyzer that analyzes the cardiointervalogram and at optimal times creates control commands for inhalation-expiration, which the patient obeys.

Practical tests of the method of organizing biological feedback with the analysis of the patient’s cardiointervalogram by the microcomputer registrar analyzer in real time showed that in some cases the nature of the change in RR-intervals during inspiration and expiration does not obey the above formulated rule and a reverse (“paradoxical”) reaction occurs, in particular in some people there was a delayed reaction of an increase (decrease) in the heart rate to inhale (exhale), which led to the appearance of other extrema following one extreme, not directly related to the phenomenon of cardiorespiratory synchronization (functional resonance), but depending on the individual characteristics of the reaction of the heart rhythm to respiratory movements. Because of this, the microcomputer recorder / analyzer issued incorrect commands. To eliminate this negative effect, an analysis blocking interval was introduced immediately after the command issued, during which the presence of an extremum does not lead to the issuance of a control command. It is advisable to take the duration of the blocking interval equal to three cardiocycles after the inhalation command and one cardiocycle after the exhalation command. This value is a compromise between errors of the first and second kind, that is, between the omission of the extremum due to the resonance properties of the cardiorespiratory system and the false positives of the extremum analyzer. The difference in the duration of these two blocking intervals is due to the different speed of the processes of increasing and decreasing RR-intervals (figure 2).

The block diagram of the algorithm of the microcontroller subroutine, providing the analysis of the cardiointervalogram and the formation of control signals taking into account the blocking interval, is presented in Fig.3.

Figure 4 presents a comparison of cardiointervalograms obtained from the same person under identical conditions by the method described in the prototype (left in figure 4) and the proposed method (right in figure 4). According to subjective feelings, the depth of relaxation when organizing biological feedback by the proposed method is higher than when organizing biological feedback by the prototype method. According to objective data, with cardiorespiratory synchronization by the prototype method, the averaged RR intervals lengthened from 0.75 to 0.87 s (heart rate decreased from 80 to 69 beats / min, respectively), and with cardiorespiratory synchronization by the proposed method, the averaged RR intervals lengthened from 0 , 76 to 1.05 s (heart rate, respectively, decreased from 79 to 57 beats / min), which reflects a greater relaxation of the patient and greater stimulation of the vagus nerve of the proposed method in comparison with the prototype. Similar results were obtained from other subjects.

A person in the proposed method of organizing biological feedback is given a passive role, i.e. a person simply obeys the commands of a microcomputer recorder-analyzer, and visual communication with technical devices is not required, sound communication is sufficient. This allows you to combine biological feedback sessions with other types of active load on the body (physical, psychological, etc.). Figure 5 presents an example of a cardiointervalogram when combining sessions of cardiorespiratory BOS training with the proposed method with a uniform load on a bicycle ergometer, and Fig.6 shows a cardiointervalogram when combining sessions of cardiorespiratory BOS training with orthostatic breakdown.

Thus, the introduction into the biofeedback circuit of a microcomputer recorder-analyzer that analyzes the cardiointervalogram and at optimal times generates control commands for inhalation-expiration, which the patient obeys, eliminates additional psychological burden on the patient in the form of an analysis of his own cardiointervalogram, and also eliminates the mandatory visual connection of the patient with technical devices, which allows to achieve greater patient relaxation, increase the effectiveness of exposure I use the methods of cardiorespiratory synchronization with the organization of biological feedback to the human autonomic nervous system, as well as increase the mobility of the entire complex of cardiorespiratory synchronization to combine biological feedback sessions with other types of active load on the body. Entering into the subroutine of the analysis of extrema of the analysis blocking intervals allows one to take into account the possibility of an individual reaction of an increase (decrease) in the heart rate to inhale (exhale) with the appearance of other extrema following one extremum that are not directly related to the phenomenon of cardiorespiratory synchronization (functional resonance) and are in this case the noise.

Information sources

1. Vashchillo E.G., Zingerman A.M., Konstantinov M.A. Study of the resonant characteristics of the cardiovascular system. // Human physiology, 1983. T.9, No. 2. S.257-265.

2. RF patent No. 2190952. A method for the treatment of opiate dependence, aggravated by neurocirculatory dystonia, in adolescents in the acute period / Yakovlev N.M., Smetankin A.A. Publ. 2002.10.20.

3. Auth. St. USSR No. 1745200. The method of functional correction of blood pressure / Gondareva L.N., Vasilevsky N.N., Seisembekov T.Z. et al., Publ. 1992.07.07.

Claims (1)

A method of functional correction of a person’s state, including registration and analysis of a patient’s cardiointervalogram in real time and synchronization of respiratory movements with fluctuations in their own heart rate: inhalation is carried out when registering the maximum of the cardiointervalogram, and exhalation is carried out when registering the minimum of the cardiointervalogram, characterized in that the person forms inspiratory-expiration commands a microcontroller based on the analysis of the current cardiointervalogram, and the inspiration command is issued m when registering the maximum of the cardiointervalogram and subject to the end of the time interval for blocking the analysis, during which the microcontroller does not issue commands even if there is an extremum, and the command for exhalation is issued when registering the minimum of the cardiointervalogram and provided that the analysis blocking time interval ends, and the analysis blocking time interval begins during an inspiratory command with a duration of three cardiocycles or an exhalation with a duration of one cardiocycle.

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